J Korean Pain Soc.  1994 Nov;7(2):287-291.

Intercostal Neuralgia and Spinal Cord compression Symptom due to Spinal Tumor: A Case Report

• Lee HK
• Shin DY
• Lee HJ
• Kim C

Abstract

A 49 years old male patient was admitted to our neuro-pain clinic with symptoms of left 1lth intercostal neuralgic pain and low back pain that developed 2 months prior to admission. Upon initial physical examination, motor weakness or sensory deficit were absent. Intercostal neuralgic pain improved significantly after we performed thoracic root thermocoagulation. However on the afternoon of the procedure the patient started to experience voiding difficulty, saddle anesthesia and rapidly progressing motor weakness and hypoesthesia that involved the lower back area and the lower extremities for three days. Based on these symptoms spinal cord compression was suspected and subsequently plain T-L spine X-rays and T-L spine MRI were performed. A spinal tumor that appeared metastatic in origin was seen at the T 11 and T12 leveL Liver ultrasonography demonstrated the presence of a 4x4 cm sized ill defined mass in the posterior segment of the right lobe. The patient was diagnosed to have hepatocellular carcinama after needle aspiration biopsy and cytologic studies. Further orthopedic surgery was recommended but as the patient rejected any further treatment and examination, it was not possible to confirm the primary focus of the tumor. However as metastasis of a primary liver tumor to the spine is a rare occurrence, some other primary focus of metastasis or even a malignant primary tumor of the spine is more likely to explain this patients condition.

Keyword

Spinal tumor; Intercostal neuralgia; Metastasis

MeSH Terms

Anesthesia
Biopsy, Needle
Electrocoagulation
Humans
Hypesthesia
Liver
Low Back Pain
Lower Extremity
Magnetic Resonance Imaging
Male
Middle Aged
Needles
Neoplasm Metastasis
Neuralgia*
Orthopedics
Physical Examination
Spinal Cord Compression*
Spinal Cord*
Spine
Ultrasonography